Technical Factors May Obscure Euthanasia Issue in Trial

Even though a 46-year-old physician’s assistant has admitted injecting his terminally ill uncle with potent drugs to hasten death, his upcoming murder trial may never explore the ethical and moral arguments of euthanasia.

Instead, the trial of Wallace Cooper, who is set for arraignment in Pasadena Superior Court on June 28, is likely to focus on the more technical questions of whether the drugs Cooper administered last Sept. 1 were the “proximate cause” of his 81-year-old uncle’s death.

During three days of preliminary hearing testimony last week, medical experts gave a preview of the trial when they disagreed completely over the cause of Wallace Goulden’s death. Goulden, who was bedridden and suffered from congestive heart failure, kidney failure and fluid in the lungs, died in his Pasadena home two hours after Cooper injected the man he was named after and regarded almost as a father with a mixture of morphine and digoxin, according to court records and interviews. Digoxin is a powerful drug that slows down the heart.

Dr. Lawrence Cogan, the deputy medical examiner for the Los Angeles County coroner’s office who performed the autopsy, testified that analysis of tissue from Goulden’s body revealed the presence of the two drugs. Cogan said the test results, coupled with evidence of a fresh vein puncture on the body, led him to conclude that Goulden died of acute morphine and digoxin intoxication.

But Cogan acknowledged that because the autopsy was not performed until two weeks after Goulden’s death--after the body had been embalmed, buried and then exhumed--it would be impossible to determine the precise level of drugs in Goulden’s body at the time of death. Thus, some extrapolation was necessary in determining the cause of death.

In a motion to the court, Ron Bain, a Los Angeles attorney representing Cooper, argued that this level of uncertainty required the dismissal of first-degree murder charges against his client. To support his contention, Bain pointed to the testimony of Dr. Robert Bucklin, a well known pathologist, who had told the court that heart disease was the sole cause of Goulden’s death.

“The prosecution simply has not established a medical causation between the administering of the drugs and death,” Bain said in arguing his motion before Pasadena Municipal Court Commissioner Kevil W. Martin. “We need to know the blood serum levels to evaluate, to estimate the dosage. Without it, everything is speculation.”

Martin, citing a less exacting burden of proof in preliminary hearings, rejected Bain’s argument and ruled that there was probable cause to bind over Cooper for trial.

“Yes, there is a conflict in the testimony between two experts,” Martin said. “But I suspect it is a question for the jury whether or not there were sufficient drugs to cause death.”

Cooper, a Pasadena physician’s assistant who was enrolled in an advanced training program at County-USC Medical Center at the time of Goulden’s death, told sheriff’s homicide detectives that he administered the drugs with the intent to kill his uncle, according to court records. Goulden was in extreme pain and had repeatedly asked family members to end his life, relatives testified at the preliminary hearing.

Cooper, who has pleaded not guilty to the charge, said in an interview that he will not recant the admission. He first admitted injecting his uncle to a hospital supervisor, who then contacted authorities. Cooper was later freed on his own recognizance by Martin, who told prosecutors that they would have to have a strong argument before he would set bail.

Shortly after the charges were filed last month, Bain said he would argue that Cooper administered the injection to his uncle out of a humane desire to end his long suffering. He said Cooper’s defense would probably center on the argument that “mercy killing” is justified in some cases on moral and ethical grounds.

At the time, Bain said he would either seek to expand case law by contending that a “right to die with assistance” should be recognized by the courts, or argue that the facts of the case mitigate Cooper’s actions and he should be charged with a lesser crime.

But after examining the coroner’s report and talking to medical experts, Bain said, he concluded that the cause of Goulden’s death could not be determined beyond a reasonable doubt. This was partly because Cooper did not tell his supervisor that he had injected his uncle with a potentially lethal dose of drugs until two weeks after Goulden died.

Bain said the inability to measure the precise level of drugs because of the delay in autopsy made it impossible to show proximate cause, a legal requirement which holds that death must be produced by a specific act without the intervention of any other significant factors.

“Right now, I’m leaning toward an argument of proximate cause,” Bain said. “I hope it never comes to a test of euthanasia. But I’m still not sure what role euthanasia will play in Mr. Cooper’s defense. It will certainly be part of my plea to the jury that his actions should not be equated with the most heinous of murders.”

In the past few years, a number of mercy killing cases have been heard in courts across the nation. Bain said no court has yet recognized the defense, either rejecting it outright or sidestepping the issue by ruling that ethical and moral considerations were mitigating factors in lessening the crimes to second-degree murder or voluntary manslaughter.

Last month, a 75-year-old Florida man who used a mercy killing defense was convicted of first-degree murder for shooting his ailing wife. Roswell Gilbert, who was sentenced to life in prison, had testified in Fort Lauderdale that he shot his 73-year-old wife out of compassion because she suffered from Alzheimer’s disease in its advanced stages.

A year ago, Dorothy Healy, a 71-year-old La Jolla woman who admitted killing her bedridden and senile 92-year-old husband, was placed on probation and fined $10,000 for involuntary manslaughter after a San Diego County judge found “moral and ethical justification” for her actions.

Cooper, who worked in rural Alaska as a physician’s assistant in the late 1970s, oversaw the care of his sick uncle for several years. Cooper said in an interview that he would often work 12-hours shifts at County-USC Medical Center and then drive to his uncle’s home to care for him.

“For the last 20 years Uncle Wally had been kind of like a dad,” Cooper said of his uncle by marriage. “My father died 20 years ago. When I was growing up, my father was a mining engineer and was gone for a year at a time. Uncle Wally often filled in for him.”

According to court documents, Goulden’s longtime physician told Cooper and other family members last Aug. 15 that Goulden’s heart was failing and that they should make funeral arrangements. The next two weeks, according to Cooper’s statements to police, Goulden experienced extreme pain and repeatedly begged Cooper to administer enough painkiller to end his life. “How many more weary miles are you going to make me travel?” Goulden asked his wife and other relatives, according to Cooper’s statement to police.

Three days before Goulden’s death, his wife and others agreed to withhold medication that regulated Goulden’s heartbeat, according to a police report. Bain said it was only after this passive measure failed that Cooper gave in to his uncle’s pleas and decided to take an affirmative step to end his life.

A few days after the death, Cooper told his supervisor at work that he injected his uncle with the combination of drugs. On Sept. 15, the supervisor contacted sheriff’s authorities and Goulden’s body was exhumed.

Susan Wondries, the deputy district attorney prosecuting the case, is expected to argue at the trial that Cooper was a well trained physician’s assistant who, wanting to end his uncle’s suffering, would know what would constitute a lethal dose of morphine and digoxin.